HomeMy WebLinkAboutPW15-389 - Amendment - #3 - A&M Consulting Company - S 228th Street UP Grade Separation Project - 10/30/2017 ds
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CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: A & M Consulting
Vendor Number:
JD Edwards Number
Contract Number:
This is assigned by City Clerk's Office
Project Name: S. 228`h St. UP Grade Separation
Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract
❑ Other:
Contract Effective Date: 10/30/17 Termination Date: 12/31/18
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Mark Madfai Department: Engineering
Contract Amount: $9,240.00
Approval Authority: (CIRCLE ONE) (Department Director Mayor City Council
------------
Detail: (i.e. address, location, parcel number, tax id, etc.):
Provide additional public and private utility coordination services for the project.
As of: 08/27/14
KETIT
AMENDMENT NO. 3
NAME OF CONSULTANT OR VENDOR: A & M Consulting
CONTRACT NAME & PROJECT NUMBER: S. 2281" St. UPGrade Separation
ORIGINAL AGREEMENT DATE: December g 2015
This Amendment is made between the City and the above-referenced Consultant or
Vendor and amends the original Agreement and all prior Amendments. All other provisions of
the original Agreement or prior Amendments not inconsistent with this Amendment shall remain
in full force and effect. For valuable consideration and by mutual consent of the parties,
Consultant or Vendor's work is modified as follows:
1. Section I of the Agreement, entitled "Description of Work," is hereby modified to
add additional work or revise existing work as follows:
In addition to work required under the original Agreement and any
prior Amendments, the Consultant or Vendor shall:
Provide additional public and private utility coordination
services for the project.
2. The contract amount and time for performance provisions of Section II "Time of
Completion," and Section III, "Compensation," are modified as follows:
...._.....
Original Contract Sum, $9,240.00
including applicable WSST
Net Change by Previous Amendments $9,240.00
including applicable WSST
Current Contract Amount $18,480.00
including all previous amendments .
Current Amendment Sum $9,240.00
Applicable WSST Tax on this $0
Amendment
Revised Contract Sum $27,720.00
AMENDMENT - 1 OF 2
.... . ...... _._.._
Original Time for Completion 12/31/16
(insert date)
Revised Time for Completion under 12/31/17
prior Amendments
(insert date)
- for this 365 calendar days
Amendment
.......... _....mm.m._m___.
Revised Time for Completion 12/31/18
(insert date)
The Consultant or Vendor accepts all requirements of this Amendment by signing below,
by its signature waives any protest or claim it may have regarding this Amendment, and
acknowledges and accepts that this Amendment constitutes full payment and final settlement of
all claims of any kind or nature arising from or connected with any work either covered or
affected by this Amendment, including, without limitation, claims related to contract time,
contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless
otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the
guarantee and warranty provisions of the original Agreement.
All acts consistent with the authority of the Agreement, previous Amendments (if any),
and this Amendment, prior to the effective date of this Amendment, are hereby ratified and
affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment
shall be deemed to have applied.
The parties whose names appear below swear under penalty of perjury that they are
authorized to enter into this Amendment, which is binding on the parties of this contract.
IN WITNESS, the parties below have executed this Amendment, which will
become effective on the last date written below.
-C ONSULT�'ANT/_V. NDO R: ,r - ._....m CTY O—K ENT:Print Name. 1 " r " ( 1< Print Name: imothv ], LaPorte, P.E.
Its - Its Pi Works Director_
G(rt�y (
jm._I DATE: �Ye ZO
DATE: `',� � /�
._w._.._. ....... ._..........__.. _....
APPROVED AS TO FORM:
(applicable if Mayor's signature required)
Kent Law Department
A&M Consulting-228" Grade Sep 4 Amid 3/Madfal
AMENDMENT - 2 OF 2
EXHIBIT A
A&M Consulting
SE 228`�' Street UP Overpass Improvements Project
Scope of Worle
The Consultant shall provide consultation services to the City for public and private utility
coordination for the SE 228th Street UP Overpass Improvements Project. These services shall
include the following:
Evaluate impacts of the City's project on private utilities' equipment.
Coordinate with Puget Sound Energy to relocate existing Puget Sound Energy electrical
facilities,
Coordinate with Puget Sound Energy on relocating gas facilities.
Coordinate with private properly owners to facilitate conversion of their private services from
overhead to underground,
Coordinate with other utilities (ZAYO, COMCAST, and Century Link) and City Staff for
construction of a joint utility trench for relocation of existing underground.facilities.
Coordinate with private utility companies for relocation of their facilities that conflict with the
City's proposed project.
Coordinate with private utilities to prepare agreements and cost estimates for new utility
relocations and to finalize costs for existing agreements.
Provide construction coordination and provide advice on resolution of conflicts related to private
utilities during construction of the City's public projects.
The estimated costs for these services will be $9240.00.
4--' I.CKIINUAIt Ur LIAWLlI Y INSUKANUE 1lo/7/201 }
THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW_ THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER
°ORTAN F: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
ABROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this
certificate doss nox confer r�yhts to the certificatehuldar In lieu of such endomementQsfl.,,,,,
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COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWT11 LANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, IHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
7 ERMS,EXCWSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_
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DESCRIPTION OF OPFRATIONS/LOCATIONS/VENAL'H!iLY)RB 101,Add'Rional Remarks Schedule,mry be athched it more space s roquved) .
Those usual to the Insured's Operations. Certificate Holder is an Additional
Insured per the Business Liability Coverage FOTTTL SS0008 attached to this
'policy.
CERTIFICATE MOLOEXt .. - CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
The -ity of Kent BEFORE THE EXPIRAI ION DATE THEREOF NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
Pub—c Woilcs Engineering AUTNORirEDRrPRrsrNrnnmE
2 2 2 4 TH AVE S' �
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IM8 2015 ACORD CORPORATION.All rights reserved.
ACORD 25 (201 6/03) The ACORD name and logo are registered marks of ACORD
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BUSINESS LIABILITY COVERAGE FORM
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QUICK REFERENCE
BUSINESS LIABILITY COVERAGE FORM
READ YOUR POLICY CAREFULLY
BUSINESS LIABILITY COVERAGE FORM Beginning on Page
A. COVERAGES 1
Business Liability 1
Medical Expenses 2
Coverage Extension-Supplementary Payments 2
B. EXCLUSIONS 3
C. WHO IS AN INSURED 10
D, LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE 14
E, LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 1s
1. Bankruptcy 15
2. Duties In The Event Of occurrence,Offense,Claim Or Bull 18
3. Financial Responsibility Laws 16
4. Legal Action AgalnstUs 16
5. Separation Of Insureds 16
6. Representatlons 18
7. Other Insurance 16
8. Transfer Of Rights Of Recovery Against Others To Us 17
F. OPTIONAL ADDITIONAL INSURED COVERAGES 16
Additional insureds 18
G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 20
M
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage, Read the entire policy carefully to determine rights,duties and what
is and Is not covered.
Throughout this policy the words"you"and"your" refer to the Named Insured shown in the Declarations. The words
"we", "us"and'burn refer to the stock Insurance company member of The Hartford providing this Insurance.
The word"insured"means any person or organization qualifying as such under Section C.-Who Is An Insured.
Other words and phrases that appear In quotation marks have special meaning. Refer to Section G• - Liability And
Medical Expenses Definitions,
A. COVERAGES (a) The "bodily injury" or "property
1. BUSINESS LIABILITY COVERAGE (BODILY damage" Is caused by an
INJURY PROPERTY DAMAGE PERSONAL "occurrence" that takes place In the
AND ADVERTISING INJURY) "coverage territory'
Insuring Agreement (b) The "bodily Injury' or "property
damage" occurs during the policy
a. Wa will pay those sums that the Insured period;and
becomes legally obligated to pay as (c) Prior to the policy period, no Insured
damages because of bodily injury", listed under Paragraph 1. of Section
"prop® damage" or "personal and g p
C. — Who Is An Insured and no
an g Injury" to which this Insurance "employee"authorized by you to glva
applies. We will have the right and duty to or receive notice of an "occurrence"
defend the Insured against any "suit" or claim,knew that the"bodily injury"
seeking those damages. However, we will or "property damage" had occurred,
have no duty to defend the Insured against In whole or In part, If such a listed
any "suit" seeking damages for ."bodily Insured or authorized "employee"
injury", "property damage"or"personal and knew,prior to the policy period, that
advertising Injury" to whloh this insurance the "bodlly injury" or "property
does notapply. damage" occurred, then any
We may, at our discretion, investigate any continuation, change or resumption
"occurrence"or offense and settle any claim of such "bodily Injury" or "property
or."s.uit"that may result. But: damage" during or after the policy
(1) The amount we will pay for damages Is period will ba deemed to have been
limped as described In Section D. known prior to the policy period.
Liability And Medical Expenses Limits (2) To "personal and advertising injury"
Of Insurance;and caused by an offense arising out of your
(2) Our right and duty to defend ends when business, but only If the offenso was
we have used up the applicable limit of committed In the "coverage territory"
Insurance in the payment of Judgments, during the policy pedod.
settlements or medical expenses to which c. "Bodily injury" or"property damage"will be
this insurance applies. deemed to have been known to have
No other obligation or liability to pay sums or occurred at the earliest time when any
perform aols or services Is covered unless insured listed under Paragraph 1.of Section
explicitly provided for under Coverage C.—Who Is An Insured or any "employee"
Extension-Supplementary Payments. authorized by you to give or receive notice
b. This Insurance applies: of an"occurrence"or claim:
(i) To "bodily injury" and "property (1) Reports all, or any part, of the "bodily
damage"only If'. any
or "property damage" to us or
any other insurer,
i
Form SS 00 00 04 05 Page 1 of 24
2005,The Hartford
BUSINESS LIABILITY COVERAGE FORM
(2) Receives a written or verbal demand or b. We wilt make these payments regardless of
cialm for damages because of the"bodily fault, These payments will not exceed the
Injury"or"property damage";or applicable limit of insurance. We will pay
(3) Becomes.aware by any other means that
reasonable expenses for:
"bodiy injury" or"property damaga" has (1) First aid administered at the time of an
occurred or has begun to 000ur, accident;
d. Damages because of'bodily injury" Include (2) Necessary medical; surgical, x-ray and
damag9es claimed by any person or dental servicss, including prosthetic
organization for care, loss of services or devices;and
death resulting at any time from the"bodily (3) Neeassary ambulance, hospital,
Injury". professional nursing and funeral
e. Incidental Medical Malpractice services.
(1) "Bodily Injury„ arising out of the 3. COVERAGE EXTENSION
rendering of or failure to render SUPPLEMENTARY PAYMENTS
professional health care services as a a. We will pay; with respect to any claim or
physician, dentist, nurse, emergency snit" we Investigate or settle, or any "suit"
medical technician or paramedio shall againstan insured we defend;
be doomed to be caused by an (1) All expenses we incur.
"occurrence",but only If; (2) Up to $1000 for the cost of hail bonds
(a) The physician, dentist, nurse, required because of accidents or trafflc
emergency medical technician or law violations arising out of the use of
paramedic is employed by you to any vehhicle to which Business Liability
provide such services;and Coverage for"bodily injury"aPPlles- We
(b) You are not engaged In the do not have to fumish these bonds.
business or occupation of providing (3) The coat of appeal bonds or bands to
such services, release a1afaohmsnta, but only for bond
(2) For the purpose of determining the amounts within the applicable limit of
limits of Insurance forincidental medical Insurance. We do not have to furnish
rnaiprsoflca, any act oar omission these bonds.
together with all related aelb or (4) All reasonable expenses Incurred by the
omissions In the furnishing of thaso Insured at our request to assist us in the
services to any one Person will be Investigation or defense of the claim or
ooneldered one"occurrence'. "suit", Including actual loss of earnings
2. MEDICAL EXPENSES up fo $Boo a day because of tlma Off
Insuring Agreement from work.
a. We will pay medical expenses as described (5) All costs taxed against the insured In
below for "bodily Injury" caused by an the"suit",
accident! (6) Prejudgment interest awarded against
(1) On premises you own or rent; the Insured
nsred we,that pp rt of the
to pdgment
aythe
(2) On ways next to premises You own or we pay, it applicable limit of Insurance,we will,not
rent;or pay any prejudgment Interest based on
(3) Because of your operations; that period of time after the offer.
provided that: (7) All Interest on the full amount of any
(1) The accident takes place in the judgment that accrues after entry of the
,,coverage tarrifory" and during the judgment and before we have paid,
policy period; offered to pay,or deposited In court the
(2) The expenses are Incurred and reported part of the judgment that is within the
to us within three years of the date of applicabia limit of insurance.
the accident;and Any amounts paid under (1) through (7)
(3) The 'injured person submits to above will not reduce the limits of Insurance.
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
Form SS 00 08 04 05
Page 2 of 24
BUSINESS LIABILITY COVERAGE FORM
b. If we defend an Insured against a "suit" So long as the above conditions are met,
and an Indemnitaa of the Insured Is also attorneys' fees Incurred by us In the
named as a party to the "suit", we will defense of that Indemnitee, necessary
defend that Indemnitee If all of the litigation expenses incurred by us and
following condlttons are met; necessary litigation expenses Incurred
(1) The "suit" against the Indemnitee by the Indemnitee at our request will be
seeks damages.for which the insured paid as Supplementary Payments.
has assumed the liability of the Notwithstanding the provisions of
Indemnitea in a contract or agreement Paragraph 1.b.(b) of Section S. —
that is an"Insured contract"; Exclusions, such payments will not be
(2) This insurance applies to such Iiability deemed to be damages for "bodily
assumed by the insured; injury"and"property damage"and will
(3) The obligation to defend,or the cost of not reduce the Limits of insurance,
the defense of, that Indemnitea, has Our obligation to defend an insured's
also been assumed by the insured In Indemnitee and to pay for attorneys' fees
the same"Insured contract"; and necessary litigation expenses as
(4) The allegations In the "suit" and the Supplementary Payments ends when:
Information We know about the 0) We have used up the applicable limit
"occurrence" are such that no conflict of Insurance in the payment of
appears to exist between the Interests judgments or settlements;or
of Ilia Insured and the Interest of the (2) The conditions set forth above, or the
Indemnitea; terms of the agreement described In
(5) The Indemnitee and the Insured ask Paragraph(6)above,are no longer met
us to bolidbot and control the defense B. EXCLUSIONS
of that Indemnities against such "Sulu' 1, Applicable To Business Liability Coverage
and agree that we can asslgn the
same counsel to defend the insured This Insurance does not apply to:
and the Indemnitaa;and a, Expected Or Intended Injury
(6) The Indemnitee: (1) "Bodily Injury" or "properly damage"
(a) Agrees In writing to: expected or intended from the
O Coop
erate erate with us in the standpoint of the Insured, This
P exclusion does not apply to "bodlly
Investigation, sr or Injury" or"property damage" resulting
defense of the"suuilt";: from the use of reasonable force to
(11) Immediately send us copies of protect persons or property;or
any demands, notices, (2) "Personal and advertising Injury" arising
summonses or legal papers out of an offense committed by, at the
received In connection with direction of or with the consent or
the"suit'; acquiescence of the Insured with the
(lil) Notlfy any other Insurer whose expectation of Infllctfng "personal and
coverage is available to the advertising injury".
Indemnitee;and b, Contractual Liability
(iv)Cooperate with us with (1) "Bodily Injury"or"propertydamego";or
respect to caordlnating other 2 "Personal and advertsin Injury"
applicable Insurance available ( ) 9
to the indemnifee;and for which the Insured Is obligated to pay
(b) Provides us with written damages by reason of the assumption of
authoftatlon to: liability In a contract or agreement.
(1) Obtain records and other This exclusion does not apply to liability
Information related to the for damages because of:
%ult";and (a) "Bodily injury","property damage"or
(II) Conduct and control the "personal and advertising Injury'that
defense of the Indemnitee in the insured would have in tha
such"suit', absence of the contract or
agreement;or
Form SS 00 03 04 05 Page 3 of 24
BUSINESS LIABILITY COVERAGE FORM
b PorfcmilnQg duties related to the
(b) assumed
-Bodily injury or tpmporty damage" ( ) conduct of the Insured's business,or
assumed to a contract or agreement
that Is an "insured oonlraat", (2) The spouse, child, parent, brother or
provided the "bodily Injury" or sister of that "employee" as a
'property damage' omrs consequence of(1)above.
subsequent to the execution of the This exclusion applies:
oontraot or agreement. Solely for (1) Whether the Insured may be liable as
the purpose of liability assumed in an employer or In any other capacity;
sill "Insured contract", reasonable and
attomaya' fees and necessary
Agitation expenses Incurred by or,for (2) To any obligation to share damages
a party other than an Insured are with or repay someone else who must
deemed to be damages because of pay damages because of the Injury.
'bodily Injury" or"property damage" This exclusion does not apply to Itabliltq
provided: assumed by the Insured under an"Insured
(I) LlablIlly to such party for, or for contract".
the cost of,that party's defense f, Pollution
has also been assumed In the (1) "Bodily injury", "property damage" or
same"insured contract and "parsonal', and advertising Injury"
(11) Such attorneys' fees and arising out of the actual, alleged or
litigation expanses are for threatened , discharge, dispersal,
defense of that party against a seepage,migration, release or escape
civil or alternative dispute of"Pollutants":
resolution proceeding In which (a) At or from any premises, site or
damages to which this location which Is or was at any
Insurance applies era alleged. time owned or occupied by, or
G. LlquorLlabllity rented or loaned to any insured'.
"Bodily Injury" or "property damage' for However, this subparagraph does
which any Insured may be held liable by not apply to:
reason of:. (1) "Bodily lnjuryr'If sustained Minh
(1) cAustng of contributing to the a building and caused by
Intoxication of any poison; smoke, fumes, vapor or soot
(2) The furnishing of alcoholic beverages to produced by or originating from.
aclul'pmont that Is used to heat,
a person under the legal drinking age or cool or dehumidify the building,
under the Influence of alcohol;or or equipment that Is used to
(3) Any statute, ordinance or regulation heat water for persona& use, by
relating to the sale, gl% distribution or the building's occupants or their
use of alcoholic beverages, guests;
This exclusion applies only If you are In the (11) "Badly Injury" of '"property'
business of mansrfactudng, dlsfdbuVn9, damage"for which you may be
selling„ serving or furnishing aicohollo held liable, If you are a
beverages. contractor and the owner or
d. Workers' Compensation And Similar lessee of such premises,site or
Laws location has been added to your
Any obligation of the, Insured under a policy as an addidonal' Insured
workers' compensation, dlsablllty benefits with respect to your ongoing
or unemployment compensation law or operations performed for that
any similar law. additional insured at that
e. Employer's Liability promises., site or location and
Bodll u such premises, site or location
Y injury"to: Is not,and never was awned or
(1) An "employee" of the Insured arlsing occupied by, or rented or
out of and in the course of: loaned to, any Insured, other
(a) Employment by the Insured;or than that additional Insured;or
Page 4 of 24 Form 89 00 08 04 05
i
BUSINESS LIABILITY COVERAGE FORM
(Ili)"Bodily Injury" or "property released as part of the
damage" arlsing out of heat, Operations being performed
smoke or fumes from a by such Insured, contractor or
"hostile fire'; subcontractor;
(b) At or from any premises, site or (11) "Bodily Injury" or "Property
location which Is or was at any damage" sustained within a
time used by or for any Insured or building and caused by the
others for the handling, storage, release of gases, fumes or
disposal, processing or treatment vapors from materials [nought
of waste; Into that building In connection
(a) tM1 hlch are or were at any t4m4 with operations being performed
transported, handled, stored, by you or on your behalf by a
treated, disposed of, or processed
contractororsubcontradtor,or
as waste by or for: (III)"Bodily Injury" or "property
(f) Any insured;or dafnago" arising out of heat,
smoke or flumes from a
(if) Any person or organization for "hostile fire";or
whom you may be legally
responslbie; (e) At or from any premises, site or
location on which any Insured or any
(d) At or from any premises, site or contractors or subcontractors
location on which any Insured or working directly or Indirectly on any
any contractors or subcontractors. Insured's behalf are parfonning
working directly or Indirectly on operations if the operations are to
any insured's behalf are test Tor, monitor, Olean up, remove,
performing operations It the contain, treat detoxify or neutralize,
'"pollutants°' are brought on or to or In any way respond to,or assess
the 'premises, site or location In the effects of;"pollutants",
connectforl with such operstlons
by such Insured, contractor or (2) Any loss, cost or expense arising out
of any:
subcontractor" However, this
subparagraph does not apply to; (a) Request demand,order or statutory
(i) "Bodily Injury'" or "property or regulatory requirement that any
damage'" arising out rO the insured or others test for, monitor,
escape of risin lubricants a clean up, remove, contain, treat,
es arc of fuels,
which are detoxify,or neutralize, or In any way
neaded to perforrn the normal respond to, or assess the effects of,
electrical, hydraulic or pollutants";or
mechanical functions (b) Claim or suit by or on 'behalf of a
necessary for the operation of governmental authority for
"moblle equipment"or Its parts, damages because of testing for,
If such fuels,lubricants or other monitoring,cleaning up,removing,
operating fluids escape horn a containing, trsatirag, detoxifying or
vehicle part designed to hold, neutralizing, or in any way
store or receive them. This responding to, or assessing the
exception does not apply If the effects of,"pollutants'.
"bodily Injury" or "property However, this paragraph does not
damage" arises out of the apply to[(ability for damages because
Intentional discharge, dispersal of 'property damage" that tile insured
or release of the fuels, would have In the absence of such
lubricants or other operating request, demand,order or statutory or
fluids, or If such fuels, regulatory requirement; or such claim
lubricants or other operating or "suit" by or on behalf of a
fluids are brought on or to the governmental authority.
prernisee, site or location weith
the Intent that they be
discharged, dispersed or
Form SS 00 08 04 05 Page 5 of 24
I
I
I
BUSINESS LIABILITY COVERAGE FORM
g. Alroraft,Auto Or Watercraft (2) The use of "mobile equlpmord! in, or
^ or"Property damage'arising while In practice or preparation for, a
"Bodily Injury prop rtti g " g prearranged raring„ speed or
out of the ownership, maintenance, use or demolition contest or In any stunting
entrustment to others of any aircraft, "auto" activity,
or watercraft owned or operated by or rented
or loaned to any insured. Us$ Inductee 1. War
operation and"loading or unloading". "Bodily injury'', "proparty damage" or
This exclusion applies even if the claims "personal and advertising Injury?', however
against any Insured allege negligence or caused„arising,directly or Indirectly"out of:
other wrongdoing In the suparvielon, hiring, (1) War,including undeclared or civil war;
employment,training or naeatitoring of others (2) Warltka action by a military force,
by that insured, If the, "occurrence" which including action in hindering or
caused the "bodliy injury" or "property defending against an actual or
damaga^ Involved the ownership, expected attack, by any govarnmant,
maintenance,use or entrustment to cih m of so4arsign or other authority using
any aircaft, "autod' or watercraft that is military personnel or other agents; or
owned or operated by or rented or loaned to
(3) Insurrection, rebellion, revolution,
anylnsured,
usurped power, or action taken by
This exclusion does not apply to;
governmental authority In hindering or
(1) A watercraft while ashore on premises defending against any ofthesa.
youown-orrent; ), Professional Services
(2) Awatercraft you do not own that Is: "Bodily Injury", "property damage"' or
(a) Less than 51 feet long;and "pstaonal and advertising Injury" arising
(b) Not being used to carry persons out of the rendering of or failure to render
fora charge; any professional service. TWO includes
(3) parking an "auto" on, or on the ways
but is not limited tot
next to, premises you own or rent, (1) legal, accounting or advertising
provided the"'auto" is not owned by or servloes;
rented or loaned to you or the insured; (2) Prepadag, approving, or falling to
(4) Liability assumed under any "Insured prepare of appcova maps, shop
contract' for the ownership, drawings, opinions, reports, surveys,
maintenance or use of aircraft or tied orders, change orders, designs or
wateroraft; drawings and specification;
(3) Supervlsory, Inspection, architectural
arising auk
(5) ,BodilyInjury.,
t,o"f ilea e '"property damage operation of any of or anginearing activities;
.o
the equipment listed In Paragraph f.(2) (4) Medical, surgtcei, dental, x-ray or
or f.(3) of the dall Nuort of '"mobile nursing services treatment, advice or
equipment';or Instfuctlon;
(6) An' aircraft that is not owned by any (5) Any,health or therapeutic servlce
Ensured and Is hired"charfered or loaned treatment,advice or instruction;
with a paid crew. However, this (6) Any service, treatment, advice or
exception does not apply if the insured Instruction for the purpose of
has any other insurance for such"bodily appoaranca or akin onhancoment; hair
injury' or "property damage", whether removal or replacement or personal
the other Insurance Is primary, excess, grooming;
contingent or on any other basis. (7) Opltcal or hearing old services
h, Mobile Equipment including the prescribing" preparation,
"Bodily injury" or "property damage" fitting, demonstration or distribution of
allsfng out of.' ophthalmic lenses and similar
(1) Thettansporlatlon of"nv0118 equipment" products or hearing aid devious;
by an "auto" owned or operated by or
rented or loaned to any insrued;or tl
page 6 of 24 Form SS 00 08 04 05
i
BUSINESS LIABILITY COVERAGE FORM
(8) Optometry or optometric services Paragraphs (1), (3) and (4) . of this
Including but not limited to examination exclusion do not apply to "property
of the eyes and the prescribing, damage" (other then damage by tire) to
preparation, fitting;demonstration or premises, Including the contents of such
distribution of ophthalmic lenses and premises,rented to you for a period of 7 or
similar products; fewer consecutive days. A separate Limit
(9) Any: of Insurance applies to Damage To
(a) Body piercing (not Including ear Promises Rented To You as described In
$ectlon 0,-Limits Of Insurance.
piercing);
(h) Tattooing, including but not limited Paragraph (2) of this exclusion does not
to the Insertion of g but n t into or apply I(the promises are "your work"and
to the Insertion
a An;and were never occupied, rented or held for
rental by you. ,
(c) Similar services; Paragraphs(3)and(4)of this exclusion do
(10) SaNICee In the practice of pharmacy; not apply to the use of elevators.
and Paragraphs (3), (4), (5) and (6) of this
(11) Computer consulting, design or exclusion do not apply to liability assumed
Programming services, Including web under a sidetrack agreement
site design. Paragraphs(3)and(4)of this exclusion do
Paragraphs(4)and(5)of this exclusion do not apply to "property damage" to.
not apply to the Incidental Medlcat borrowed equipment while not being used
Malpraeffes coverage afforded under to perform operations at a job site,
Paragraph 1,e.In Section A.-Coverages. Paragraph (6) of this excluslon does not
k. Damage To Property apply to "property damage"Included In the
"Property damage"to: "produets-completed operalons hazard".
(1) Property you own, rent or occupy, I. Damage To Your Product
including any costs or expenses "Property damage" to "your product'
Incurred by you, or any other person, arising outof It orany part of it.
organization or entity, for repair, m, Damage To Your Work
replacement, enhancement,
operty damage" to
restoration or maintenance of such "Pr "your work" arising
property for any reason, Including outof It or any part of It and Included In the
prevention of Injury to a person or "products-completed operations hazard",
damage to another's property; This excluslon does not apply If the
(2) Premises you sell, give away or damaged work or the work out of which
abandon,if the"property damage"arises the damage arises was perforated on your
out of any part of those premises; behalf by a subcontractor,
(3) Property loaned to you; n. Damage To Impaired Property Or
Property Not Physically Injured
(4) Personal property in the care,custody Or control of the Insured; "Property damage" to "impaired property"
or property that has not been physically .
(5) That particular part of real property on injured,arising out of:
which you or any contractors or {1) A defect, deficiency, Inadequacy or
subcontractors woridng directly or A defect,
condition in "your products
Indirectly on your behalf are performing
operations, If the "property damage" or"your work";or
arises cutof those operations;or (2) A delay or failure by you or anyone
(6) That particular part of any property acting on your behalf to perform a
that must be restored, repaired or contract or agreement In accordance
replaced because "your work" was with Its terms.
incorrectly performed on it, This exclusion does not apply to the loss
of use of other property arising out of
sudden and accidental physical injury to
"your product" or "your work" after It has
been put to its Intended use.
Form SS 09 03 04 05 Page 7 of 24
BUSINESS LIABILITY COVERAGE FORM
o. Recall Of Products, Work Or Impaired (c) Title of any literary or artistic work;
Property (8) Arising out of an Offense committed by
Damages claimed for any loss, cost or an Insured whose business Is;
expense Incurred by you Or others for the (a) verg , teleces8 broadcasting,
loss of use, withdrawal, recall, Inspection, publishing
repair, replacement, adjustment, removal (b) Designing or dgtermtning content
or disposal of; of web sites for others;or
(1) "your product"; (a) An Internet search, access-
(2) "Your work';or content or service provider,
(3) "Impalred property"; However, this exONGIOn does not
if stroh product, work, Or prOpaaty is apply to paragraph's a., b" and, c,
withdrawn or recalled from the market or under the deflni€ion of "personal and
from use by any person or organization advertising Injury, In Section G. —
because of a known or suspeOtad,defrtOt, Liability And Medical Expenses
deficiency, Inadequacy Or dangerous Datintlons.
condition in It. For the purposes Of this exclusion,
p. Personal And Advertising Injury placing uking loan"a vertisement" for Of
your web sits, by
"Personal and advertising Injury": Itself, is not considered the business
(1j Arising out of oral,wrilton or eioclmo[O of advertising, broadcasting,
pveffostion of material,if done by or at publlshing or telecasting;
tba direction of Via insured with (9) Arising out of an electronic chat room
knowledge of ltsfelsity; or bulletin board the Insured hosts,
(2) Arising out of oral,written or electronic owns, or over which the Insured
publication of material whose fret exercises control;
publication took place before the (10) Arising out of the unauthorized use Of
beginning of the policy period; another's name Or product In your O-mall
(3) Arising out of a criminal act committed address„domain name or metatags,or
by or at the dlrecdon of the Insured; any other similar tactics to mislead
(4) Arising cut of any breach of contract, another'spotential customers;
except an implied contract, to use (11) Arls(ng out of the violation of a
anther's "advertising Idea" In your person's right of privacy created by
"advertisement'; any state or federal act,
(5) Arising out of the failure of goods, Howevar; this exclusion sloes not
products or services to confOnn with apply to liability for damages that the
any statement of quality or Insured would have In the absence of
performance made 'in your such state or federal act;
"advertisement"; (12) Arising out oft
(6) Arising out Of the wrong descdptlon of (a) An "advertisement" for others on
the price of goods,products erservlces; your web site;
(7) Arising out of any violation of any (b) Placing a link to a web site of
Intellectual property rights such as others on your web site:
copyright, patent, trademark, trade
name, trade socrot servdoe mark Or (c) Content from within web
rna or bottler
690 Of Others
displ
authau8t
denticlty"aslgnation , of origin or on your web site. Content Includes
Information, coda, snurads, text,
However, this exclusion does not graphics or Images;or
apply to Infringement, in your
"advertisement",of (d) Computer code, software or
(a) Copyright; programming used to enable.
(i) Yourweb site;or
(b) atrade" unless the slogan is also (it) The presontation orfunotionallty
a trademark, trade neme, fortuln of an "adverisement" or other
mark or other;or
Of origin content on your web site;
or authenticity;or
Form SS 00 08 04 05
Page 8 of 24
BUSINESS LIABILITY COVERAGE FORM
(13) Arising out of a vlolatlon of any anti- (a) May be awarded or Incurred by
trust law; reason of any claim or suit
(14) Arising out of the fluctuation to price or alleging actual or threatened Injury
value of any stocks, bonds or other or damage of any nature or kind to
seourt0as;or persons or property which Would'
16 Arisln out of discrlmination or not have occurred In whole or in
g pad but for the"asbestos hazard";
humiliation committed by or at the
direction of any "executive officer", (b) Arise out of any request,demand,
director, stockhoider, partner or order or statutory or regulatory
member of the insured, requirement that any insured or
Electron)e Dat others test for, monitor, clean up,
al a remove, encapsulate, contain,
Dams as arising out of tha foss of, Coss of treat, detoxify or neutralize or In
use of, damage to, corruption of, inability any way respond to or assess the
to access, or Inability to manipulate effects of an"asbestos hazard";or. .
"alectronfo data". (a) Arise out of any claim or suit for
r. Employment•Retated Practices damages because of testfog for,
"Bedify,injury"or"personal and advertising monitoring, cleaning up, removing,
injury„to: enapsulaiing, containing, treating,
(1) A person arising out of any: detoxtPying or noutrallzIg or In any
way responding to or assessing the
(a) Refusal to employ that person; pde&ofan"asl;rastedshazard".
(b) Terminatlon of that person's t. Violation Of Statutes That Govern E-
employment;or Malls, Fax, Phone Calls Or Other
(a) Employment-related practices, Methods Of Sending Material Or
potcles, acts or omissions, such as Information
coercion, demotion, Valuation, "Bodily injury", "property damage", or
reassignment, dlsolpine, "personal and advedlsing Injury" arising
defamation,harassment,humiliation directly or indirectly out of any action or
or discrimination directed at that omisslon that violates or is alleged to
person;or violate:
(2) The spouse, child, parent, brother or (1) The Telephone Consumer Protection
sister of that person as a Act(TCPA), Including any amendment
consequence of "bodily Injury" or of or addition to such law;
"personal and advertising injury"to the (2) The CAN-SPAM Act of 2003,including
parson at whom any of the any amendment of or addition to such
employment related practices law;or
described In Paragraphs(a), (b),or(c)
above Is directed, (3) Arty statute, Otdlnar a or regulation,
This exclusion applies; other than the'TCPA or CAN-SPAM Act
PP of 2003, that prohibits or limits the
(1) Whether the Insured may be liable as sending,transmtting, communicating or
an employer or in any other capacity; distribution of material or information.
and Damage To Premises Rented To You —
(2) To any obligation to share damages Exception For Damage By Fire, Lightning
with or repay someone else who must or Explosion
pay damages because of the injury. Exclusions c,through h.and k.through o. do
s. Asbestos not apply to damage by tire„ lightning or
(1) "Bodity, Injury", „property damage" or expfoalon to premises rented to you or
"personal and advertising Injury' temporarily occupied,by you with permission of
arising out of the"asbestos hazard", the owner. A separate Limit of Insurance
(2) Any damages, Judgments, settlements, applies to this coverage as described in
Any damagecosts or expens eats, Section D. - Liability And Medical Expenses
lossLimits Of Insurance.
1,
Form SS 00 08 04 05 Page 9 of 24
G BUSINESS LIABILITY COVERAGE FORM
2. Applicable To Medical Expenses Coverage e. A trust,you are an Insured. Your trusties
We will not pay expenses for"bodily Injury"; are also Insureds, but only with respect to
their duties as trustees.
i a, Any Insured 2, Each of the following Is also an Insureds
To any insured,except"volunteer workers
a. Employees And Volunteer Workers
b. Hired Person
To a person hired to do work for or on behalf Your "volunteer workers° only while
of any insured oratenent of any Insured, performing duties related to Ilia conduct of
your husiness,or your"ampkoyees", other
a. Injury On Normally Occupied Premises than either your"executive,officers'"Of you
To a person injured on that part of are an organitatlon other than a
promises you own or rent that the person partnership,joint venture or limited'liability
normailyoccuples, oompany)or your managers (if you are a
d. Workers' Compensation And Similar limited liability company), but only for solo
Laws within the scope of their employment by
you or while performing duties related to
To a persoh, whether or not an the conduct of your business.
ampinyaa°4 of any Insured, If banatlls for However, none of these "employees" or
the "bodily Injury' are payable or must be ^volunteer workers"are Insureds for:
provided under a workers compensation
orcilsoblllty benefits law ora similar law. (1) "Bodily injury" or "personal end
a" Athletics Activities 9 advertising injury":
(a) To you, to your, partners or
-I'o a person Injured whllo praotlo{ng, members(if you are a partnership
instructing or participating in any physlcal ' orjolpt venture)"to your members
exercises or games, sports or athletic (If you are a limited ilablity
contests. tbf)yeny), or to a co,"employed"
f, Products-Completed Operations Hazard wh,lki in the Course of his or her
included with the "products-completed ampisymont or performing duties
operations hazard". related to the conduct of your
g, Business Liability Exclusions business, or to your other
"volunteer workers" while
Excluded under Business Liability Coverage, performing duties related to the
C. WHO IS AN INSURED conduct of your business;
1. If you are designated in the Ceclaratlens as: (b) To the spouse, child, parent,
co-
a. An Individual, you and your spcusd are brother e" sister of that"volunteer
Insureds, but only with respect to the orkee'ea or that consequence
conduct of a business of which you are the Paragraph
as a above: ence of
sole owner.
Paragraph(1)(a)above;
b. A partnership or joint venture, you are art (a) For which ghara Is any obligation
to share damages with or repay
insured. Your members,your pa tnara,and someone also who must pay
their$pouses are also Insureds,butonlywith damages because of the injury
respecttotheoonductof your business. described in Paragraphs (1)(a) or
c. A limped Ilabliity company, you are an (b) above;or
Insured. Your members are also Insureds, (d) Arising out of his or her providing
but only whir respect to ille conduct of your or failing to provide professional
business. Your managers are Insureds,but health taro services.
only with respect to their duties as your
managers. It you are not to the business of
d. An organization other than a parPnarshlp, providing professional health care
joint venture or Gimped liability company,you son ices, Paragraph er enc not apply
all
sia an insured, Your"executiveolftcers"and to any nurse, emergency medley
directors are Insureds,but only wltr.respect techniciantopo or uch servidkl employed by
to their duties as your officers or directors. you to p ovide such services.
ces.
Your stockholders are also Insureds„but only (2) "Property damage"to property:
with respectto their Ilablllty as stockholders. (a) Owned,occupied or used by,
Page 10 of 24
Form SS 00 OB 04 05
BUSINESS LIABILITY COVERAGE FORM
(b) Rented to, in the care, custody or b. Coverage under this provision does not
control of, or over which physical apply to:
control Is being, axerclsed for any (1) "Bodily Injury" or "property damage"
purpose by you, any of your Utatocourred;or
"employees", "volunteer workers", (2) "Personal and advertising Injury"
any partnership
or r jointmember (if you are arising out of an offense committed
a partnership or joint venture), or .
any member of you are a limited before you acquired or formed the
lleblllty Gcmpany). organization,
b. Real Estate Manager 4, Operator Of Mobile Equipment
Anyperson(otherthan your"employee"or With respect to"mobile equipment" registered In
"volunteer worker"), or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an Insured while driving such
a.. Temporary Custodians Of Your equipment along a public highway with your
`Property Permission. Any other person or organlzallon
Any person or organization having proper responsible for the conduct of such person Is
p also an Insured,but only with respect to Ilablilty
temporary custody of your property It you arising out of the operation of the equipment,and
dle,but only; only If no other insurance of any kind is available
(1) With respect to Ilablllty arising out of the to that person or organlzalfon for this liability.
maintenance Grose of that property;and however,no Person ororgantzatfon is an insured
(2) Until your legal representative has with respect to:
been appointed, a, "Bodily injury" to a o&1employee"' of the
d. Legal Representative if You Ole person driving the equipment;or
Your legal representative if you die, but b. "Property damage" to property owned by,
only with respect to dudes as such. That rented to, In the charge of or occupied by
representative will have all your rights and you or the empfoyor of any person who Is
dudes under this insurance. an Insured under this provision.
e. Unnamed Subsidiary 5. Operator of NonGWn8d Watercraft
Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that
yours which Is a legally incorporated entity Is fess than 51 feet long and is not being used
of wMch you own a financial interest of to carry persons for a charge,any person Is an
more than 50% of the voting stock on the Insured while operating such watercraft with
effactivs date of this Coverage Part, your permission. Any other person or
The insurance afforded hereto for any organtzatlon responsible for the conduct of
subsidiary not shown In tha Declaratlans such person is also an Insured, but only with
as a named insured does not apply to espeet to liability arising out of the operation
injury or damage with respect to which an of the watercraft, and only If no other
insured under this Insurance Is also an insurance of any kind Is available to that
Insured under another pulley or would be
person or organization for this liability.
an insured under such policy but for its However, no person or organization Is an
termination or upon the exhaustion of Its Insured with respect to:
limits of Insurance. a. "Bodily Injury" to a co-"employee" of the
3. NewlyAcqufred Or Formed Organization person operating the watercraft;or
Any organization you newly acquire or form, b. "Property damage"to property owned by,
other than a partnership, joint venture or rented to, In the charge of or occupled by
limited liability company, and over which you you or the employer of any person who is
maintain financial Interest of more than 50% of an Insured under this provision,
the voting stock, will qualify as a Named 0. Additional insureds When Required By
Insured if there Is no other sfmtfar Insurance Written Contract, Written Agreement Or
available to that organlzaHon. However: Permit
a. Coverage under this provlslon is afforded The person(s) or organtzatfon(s) identltied in
only unfil the 180th day after you acquire Paragraphs a. through f. befow are additional
or form the organization or the and of the insureds when you have agreed, In a wrilten
policy period,whfohever Is earlier;and
Form SS 00 08 04 05 Page 11 of 24
'BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (a) Any fallura toake soda
parmlt issued by a state or political napecilons, adjustments, lasts or
subdivislon, that such person or organization servloing as the vendor has
be added as an additional Insured on your agreed to make or normally
al
pDllcy, provided the Injury or damage occurs course
undertakes to make In the coon
subsequent to the execution of the contract or with the
of distribution
business, In connection
of the
agreement,or the issuance of the permit. with the distribution or sale of the
products;
A person or organization Is an additional (l) Domoaatratien, installation,
Insured under this provision only for that servicing, or repair opsraltons„
period of (live required by the contract, except such operatl'ons performed
agreement or permit. at the, vendors promisee In
However,no such person or organization Is an nenneotlon with the sale of the
additional insured under this provision If such product;
person or organization Is Included as an (q) Products which, after distribution
additional Insured by an endorsement Issued or safe by you,have been labeled
by us and made a part of He Coverage Part; or relabeled or used as a
Including all persons or organizations added oontalner,part or Ingredient ofBOY
as additional Insureds under the specific other thing or substance by or for
additional Insured covorago grants In Section the vendor;or
F.—optional Additional Insured Coverages, l (la) «,eddy lnjury," or "property
a, Vendors damage arising out of the solo
Any porson(s)or organlzatlon(s (reforred to negligence of the vendor for Its
below as vendor); but only w' respect to own acts or Omissions or those of
"bodily Injury" or"PrOPad1"damage" arising Its employees or anyone else
out of 'your products"which are distributed acting on its behalf. However,this
or sold n the regular course of the vandoes exclusion does not apply to,
business and only If thts Coverage Fart (1) Tha exceptions contained In
provides coverage for "bodily ktfmy or Subparagraphs(d)or ft or
"property damage" included wl in the
"products-completed operations hazard'". (tl) lastSucs or
adjustments,
teals or servicing as,the vendor
(1) The Insurance affordad to the vendor has agreed to make or normally
Is subject to the following additional undertakes to make In the usual
exclusions: course of business, In
This Insurance does not apply to: connection with the distribufon
(a) °Bodily injury" or "property or saleoftheproducts.
damaga"" for which the vendor Is (2') This Insurance does not apply to any
pbllgated to pay demagas by Ensured person or organization frcaN
reason of the assunrptfen Of whom you have acquired such products„
likability In a contract or agreement, or any Ingredient; part or confatrler,
This exciuslon does not applY to entering Into, scoompanylng or
Ilablllty for damages that the contstnlng such products.
vendor would have In the absence b. Lessors Of Equipment
of the contract or agreement;
(1) Any parson or organization free
(b) Any express warranty whom you lease equipment; but only
unauthorized by you; with respect to their Itabillty for"bodily
(c) Any physfcal or chemical change Injury", °property darnago" or
In the product made Intentionally ,personal and advertising Injury"
by the vendor, caused, In whole or In part; by Your
(d) Repackaglog, except when maintenance, operation or use of
unpacked solely for the purpose of equipment
or organization, you by such
mspoction, demonstration, testing. parson
or the substitution of parts under
Instructions from the manufacturer,
and then repackaged In the
original container,
Form SS 0o 03 04 05
Page 12 of 24